Presentation
Hematuria.
Patient Data
Left renal upper polar irregular infiltrative hypodense soft tissue mass lesion showing exophytic perinephric sheet-like masses invading the left adrenal gland and merging with the multiple partially amalgamated left renal hilar and para-aortic lymph nodes.
Multiple osteolytic lesions are seen involving the right 7th and 8th ribs as well as the left iliac bone.
Bilateral upper lobar two small pulmonary nodules.
Radiological findings are suggestive of left renal and perinephric lymphoma rather than RCC, associated with metastatic abdominal lymphadenopathy, pulmonary nodules and osseous lesions.
Biopsy revealed clear cell RCC.
Case Discussion
The radiological features of the renal lesion which appears ill-defined and infiltrative, as well as the perinephric sheet-like soft tissue components invading the left adrenal gland were initially suggestive of renal and perinephric lymphoma rather than RCC. However, biopsy revealed clear cell renal cell carcinoma.
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